Underrecognition of preexisting cognitive impairment by physicians in older ICU patients.

Abstract:

OBJECTIVES:Cognitive impairment increases with age, as do many serious illnesses requiring intensive care. Little is known, however, about physician recognition of preexisting cognitive impairment in the ICU and which patient factors may play a role in physician recognition. DESIGN:Cross-sectional comparative study. SETTING:Urban university teaching hospital. PARTICIPANTS:A total of 165 patients aged > or =65 years who were admitted to the medical ICU. MEASUREMENTS:Two previously validated proxy measures of cognitive impairment, the modified Blessed dementia rating scale and the informant questionnaire on cognitive decline in the elderly. Physician interviews and medical record abstraction were used to evaluate the recognition of cognitive impairment. RESULTS:The prevalence of preexisting cognitive impairment in the ICU was 37%. Attending physicians were unaware of the preexisting cognitive impairment in 53% of cases, and intern physicians were unaware in 59% of cases. The recognition of preexisting cognitive impairment increased as the severity of the cognitive impairment increased. Two independent risk factors were identified that were significantly associated with the increased recognition of preexisting cognitive impairment (ie, impairment in activities of daily living or being admitted to the ICU from a nursing home). If both were present, preexisting cognitive impairment was 13 times more likely to be recognized. CONCLUSIONS:A substantial number of older ICU patients have preexisting cognitive impairment on admission to the ICU, and ICU physicians caring for these patients are unaware of this cognitive impairment in the majority of cases. Future research is needed to identify outcomes related to preexisting cognitive impairment and to improve its recognition.

journal_name

Chest

journal_title

Chest

authors

Pisani MA,Redlich C,McNicoll L,Ely EW,Inouye SK

doi

10.1378/chest.124.6.2267

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

2267-74

issue

6

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)31688-3

journal_volume

124

pub_type

杂志文章

相关文献

CHEST文献大全
  • The maximal expiratory flow-volume curve in normal subjects in India.

    abstract::Data on pulmonary function, with particular reference to flow-volumes, were obtained in 760 normal healthy Indians in Bombay, who had never smoked and who had no symptom or history of cardiorespiratory disease. Prediction equations were derived for spirometric parameters and for maximal expiratory flows. The maximal e...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.89.6.852

    authors: Udwadia FE,Sunavala JD,Shetye VM,Jain PK

    更新日期:1986-06-01 00:00:00

  • Ventilatory and metabolic effects of glucose infusions.

    abstract::It has been demonstrated that total parenteral nutrition (TPN) results in increased O2 consumption (VO2), CO2 production (VCO2) and minute ventilation (VE). TPN consists of a mixture of glucose and amino acids. The individual role of each of these nutrients in mediating these changes has not been well established. To ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.88.4.512

    authors: Rodriguez JL,Askanazi J,Weissman C,Hensle TW,Rosenbaum SH,Kinney JM

    更新日期:1985-10-01 00:00:00

  • Structural changes in airway diseases: characteristics, mechanisms, consequences, and pharmacologic modulation.

    abstract::In airway diseases such as asthma and COPD, specific structural changes may be observed, very likely secondary to an underlying inflammatory process. Although it is still controversial, airway remodeling may contribute to the development of these diseases and to their clinical expression and outcome. Airway remodeling...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.129.4.1068

    authors: Bergeron C,Boulet LP

    更新日期:2006-04-01 00:00:00

  • Response characteristics of a dual transcutaneous oxygen/carbon dioxide monitoring system.

    abstract::We tested the response characteristics of a dual transcutaneous (tc) PO2/PCO2 monitoring system in healthy subjects who breathed various gas mixtures, and we compared steady-state tc readings to simultaneous arterial blood gas analysis in 20 stable respiratory outpatients. The electrodes were simple to apply, required...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.5.1211

    authors: Kesten S,Chapman KR,Rebuck AS

    更新日期:1991-05-01 00:00:00

  • The Master Settlement Agreement and its impact on tobacco use 10 years later: lessons for physicians about health policy making.

    abstract::The issue of tobacco industry responsibility for population health problems and compensation for their treatment has been growing since the 1960s. In 1999, the state attorneys general collectively launched the largest class action lawsuit in US history and sued the tobacco industry to recover the costs of caring for s...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.09-0982

    authors: Jones WJ,Silvestri GA

    更新日期:2010-03-01 00:00:00

  • Nearly fatal idiopathic anaphylactic reaction resulting in cardiovascular collapse and myocardial infarction.

    abstract::We report a case of nearly fatal cardiovascular collapse attributable to an idiopathic anaphylactic reaction in a 76-year-old man. The event began with gastrointestinal symptoms of abdominal cramps, diarrhea, nausea, and vomiting as manifestations of IA. The patient subsequently progressed to develop urticaria, flushi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.2.501

    authors: Wong S,Greenberger PA,Patterson R

    更新日期:1990-08-01 00:00:00

  • Effect of weight loss on the ECG of normotensive morbidly obese patients.

    abstract:BACKGROUND:Morbid obesity produces a variety of ECG alterations, including leftward shifts of the P-wave, QRS, and T-wave axes; disproportionately high frequencies of low QRS voltage; left ventricular hypertrophy and left atrial abnormality; and a high frequency of T-wave flattening in the inferior and lateral leads. T...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.119.2.507

    authors: Alpert MA,Terry BE,Hamm CR,Fan TM,Cohen MV,Massey CV,Painter JA

    更新日期:2001-02-01 00:00:00

  • Costs of Workplace Productivity Loss in Patients With Fibrotic Interstitial Lung Disease.

    abstract:BACKGROUND:Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD. METHODS:Patients with idiopathic pulm...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2019.04.016

    authors: Algamdi M,Sadatsafavi M,Fisher JH,Morisset J,Johannson KA,Fell CD,Kolb M,Manganas H,Cox G,Gershon AS,Halayko AJ,Hambly N,Khalil N,Shapera S,To T,Wilcox PG,Guler S,Ryerson CJ

    更新日期:2019-11-01 00:00:00

  • Deep vein thrombosis among patients entering cardiac rehabilitation after coronary artery bypass surgery.

    abstract:BACKGROUND:Little information is available about the prevalence of deep vein thrombosis (DVT) after discharge from cardiac surgery units and its impact on rehabilitation programs. OBJECTIVES:To estimate the rate of DVT, in relation to different thromboprophylaxis strategies, in patients with a recent coronary artery b...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.125.1.191

    authors: Ambrosetti M,Salerno M,Zambelli M,Mastropasqua F,Tramarin R,Pedretti RF

    更新日期:2004-01-01 00:00:00

  • Sleepiness and hypertension in obstructive sleep apnea.

    abstract::In order to assess the complications of sleep apnea, we have reviewed a data base of 619 consecutive admissions to a university sleep disorders center. Although patients with obstructive sleep apnea (OSA) described more subjective sleepiness than patients with central sleep apnea (CSA) or primary snoring (PS), the mul...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.4.903

    authors: Mendelson WB

    更新日期:1992-04-01 00:00:00

  • Prevalence of pulmonary hypertension in limited and diffuse scleroderma.

    abstract:STUDY OBJECTIVES:To characterize the prevalence of undiagnosed pulmonary hypertension in patients with limited and diffuse scleroderma. DESIGN:Prospective cross-sectional study. SETTING:University-based outpatient clinic. PATIENTS:Thirty-four consecutive patients with limited (n = 29) or diffuse (n = 5) scleroderma ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.110.6.1515

    authors: Battle RW,Davitt MA,Cooper SM,Buckley LM,Leib ES,Beglin PA,Tischler MD

    更新日期:1996-12-01 00:00:00

  • An approach to mediastinal masses associated with hyperthyroidism.

    abstract::Benign thymic hyperplasia (BTH) is a known feature of hyperthyroidism, but is infrequently appreciated by clinicians. In most cases thymic enlargement is minimal; however, it may occasionally present as an appreciable anterior mediastinal mass. While surgical resection is a common approach to such a mass, recognition ...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.90.5.691

    authors: White SR,Hall JB,Little A

    更新日期:1986-11-01 00:00:00

  • Pharmacodynamics of levofloxacin in patients with acute exacerbation of chronic bronchitis.

    abstract:STUDY OBJECTIVES:Levofloxacin is a fluoroquinolone antimicrobial agent for which pharmacodynamic relationships between the maximum serum antibiotic concentration (Cmax)/minimum inhibitory concentration (MIC) ratio and/or the area under the serum concentration-time curve during a 24-h dosing period (AUC(0-24))/MIC ratio...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.128.4.2093

    authors: Cazzola M,Matera MG,Donnarumma G,Tufano MA,Sanduzzi A,Marchetti F,Blasi F

    更新日期:2005-10-01 00:00:00

  • Pulmonary embolism among patients with a nearly normal ventilation/perfusion lung scan.

    abstract:BACKGROUND:Among patients with nearly normal ventilation/perfusion (V/Q) lung scans in the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED), pulmonary embolism (PE) was diagnosed more frequently in those who underwent pulmonary angiography than in those in whom PE was diagnosed on the basis of an adve...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.110.2.395

    authors: Henry JW,Stein PD,Gottschalk A,Raskob GE

    更新日期:1996-08-01 00:00:00

  • Differential diagnostic value of plasma cells in bronchoalveolar lavage fluid.

    abstract::The aim of this study was to investigate whether the demonstration of plasma cells (PC), which are normally absent in bronchoalveolar lavage (BAL) fluid, facilitates differentiation among pulmonary disorders. Initial BAL fluid samples of 1,260 patients were analyzed. In 83 of these, PC were found. Of these 83, 47 were...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.6.1720

    authors: Drent M,van Velzen-Blad H,Diamant M,Wagenaar SS,Donckerwolck-Bogaert M,van den Bosch JM

    更新日期:1993-06-01 00:00:00

  • Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis.

    abstract:STUDY OBJECTIVES:To evaluate the long-term clinical course of patients with idiopathic pulmonary fibrosis (IPF) complicated with pulmonary arterial hypertension. DESIGN:Prospective analysis of consecutive IPF patients undergoing initial workup with right-heart catheterization (RHC) and pulmonary function testing (PFT)...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.06-1466

    authors: Hamada K,Nagai S,Tanaka S,Handa T,Shigematsu M,Nagao T,Mishima M,Kitaichi M,Izumi T

    更新日期:2007-03-01 00:00:00

  • Influenza A pneumonitis following treatment of acute cardiac allograft rejection with murine monoclonal anti-CD3 antibody (OKT3).

    abstract::A 51-year-old man developed fever, cough, and dyspnea 5 days after completing murine monoclonal anti-CD3 antibody (OKT3) treatment for acute cardiac allograft rejection. Samples of BAL fluid grew influenza A virus. Progressive pulmonary infiltrates, respiratory compromise, and hypoxia developed, and the patient ultima...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.108.5.1456

    authors: Embrey RP,Geist LJ

    更新日期:1995-11-01 00:00:00

  • Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma.

    abstract:BACKGROUND:The accuracy of combined clinical examination (CE) and chest radiography (CXR) (CE + CXR) vs thoracic ultrasonography in the acute assessment of pneumothorax, hemothorax, and lung contusion in chest trauma patients is unknown. METHODS:We conducted a prospective, observational cohort study involving 119 adul...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.11-0208

    authors: Hyacinthe AC,Broux C,Francony G,Genty C,Bouzat P,Jacquot C,Albaladejo P,Ferretti GR,Bosson JL,Payen JF

    更新日期:2012-05-01 00:00:00

  • Survival in systemic sclerosis with pulmonary arterial hypertension has not improved in the modern era.

    abstract:BACKGROUND:The impact of modern therapy on survival in pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc) is not clear. We sought to determine associations among commonly used clinical and hemodynamic variables, treatment, and long-term survival in PAH associated with SSc compared with PAH d...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.12-0653

    authors: Rubenfire M,Huffman MD,Krishnan S,Seibold JR,Schiopu E,McLaughlin VV

    更新日期:2013-10-01 00:00:00

  • Delivery of albuterol and ipratropium bromide from two nebulizer systems in chronic stable asthma. Efficacy and pulmonary deposition.

    abstract::Bronchodilator responses to both nebulized albuterol (salbutamol) and ipratropium bromide and aerosol delivery to the tracheobronchial tree have been assessed in eight patients with chronic stable asthma (mean baseline FEV1, 50 percent; reversibility greater than 20 percent). Two commercially available nebulizer syste...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.96.1.6

    authors: Johnson MA,Newman SP,Bloom R,Talaee N,Clarke SW

    更新日期:1989-07-01 00:00:00

  • Acute lung injury outside of the ICU: incidence in respiratory isolation on a general ward.

    abstract:BACKGROUND:Epidemiologic investigations of acute lung injury (ALI) and ARDS have focused on mechanically ventilated patients in ICUs, and have reported high mortality rates. We sought to determine the incidence and lethality of these syndromes in the respiratory isolation areas of general wards, a non-ICU setting that ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.08-0280

    authors: Quartin AA,Campos MA,Maldonado DA,Ashkin D,Cely CM,Schein RMH

    更新日期:2009-02-01 00:00:00

  • Atrial fibrillation following pulse methylprednisolone therapy in an adult.

    abstract::The authors believe this to be the first case report of atrial fibrillation following pulse methylprednisolone therapy in an adult. The literature regarding the complications of pulse methylprednisolone therapy is reviewed, with particular emphasis on the incidence and pathogenesis of arrhythmias. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.2.622

    authors: McLuckie AE,Savage RW

    更新日期:1993-08-01 00:00:00

  • High-Flow Nasal Cannula in the Immediate Postoperative Period: A Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Studies have demonstrated that high-flow nasal cannula (HFNC) prevents intubation in acute hypoxic respiratory failure when compared with conventional oxygen therapy (COT). However, the data examining routine HFNC use in the immediate postoperative period are less clear. RESEARCH QUESTION:Is routine HFNC us...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2020.06.038

    authors: Chaudhuri D,Granton D,Wang DX,Burns KEA,Helviz Y,Einav S,Trivedi V,Mauri T,Ricard JD,Mancebo J,Frat JP,Jog S,Hernandez G,Maggiore SM,Mbuagbaw L,Hodgson CL,Jaber S,Goligher EC,Brochard L,Rochwerg B

    更新日期:2020-11-01 00:00:00

  • Distinguishing Smoking-Related Lung Disease Phenotypes Via Imaging and Molecular Features.

    abstract:BACKGROUND:Chronic tobacco smoke exposure results in a broad range of lung pathologies including emphysema, airway disease and parenchymal fibrosis as well as a multitude of extra-pulmonary comorbidities. Prior work using CT imaging has identified several clinically relevant subgroups of smoking related lung disease, b...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2020.08.2115

    authors: Billatos E,Ash SY,Duan F,Xu K,Romanoff J,Marques H,Moses E,Han MK,Regan EA,Bowler RP,Mason SE,Doyle TJ,San José Estépar R,Rosas IO,Ross JC,Xiao X,Liu H,Liu G,Sukumar G,Wilkerson M,Dalgard C,Stevenson C,Whitney

    更新日期:2020-09-16 00:00:00

  • Patient Engagement Using New Technology to Improve Adherence to Positive Airway Pressure Therapy: A Retrospective Analysis.

    abstract:BACKGROUND:Sleep apnea has major neurocognitive and cardiovascular and metabolic risks. Treatment of sleep apnea is suboptimal because of variable adherence to existing therapies. METHODS:This trial compared positive airway pressure adherence among patients who were provided active patient engagement (APE) technology ...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1016/j.chest.2017.11.005

    authors: Malhotra A,Crocker ME,Willes L,Kelly C,Lynch S,Benjafield AV

    更新日期:2018-04-01 00:00:00

  • Ventricular inversion associated with normally related great vessels.

    abstract::A patient with ventricular inversion with normally related great vessels and double inlet left ventricle is presented. the patient also showed features of Down's syndrome. Association of ventricular inversion with normally related great vessels is rare and leads to a basic functional state like that of complete transp...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.67.1.98

    authors: Tandon R,Moller JH,Edwards JE

    更新日期:1975-01-01 00:00:00

  • A 37-Year-Old Man With Pleuritic Chest Pain.

    abstract:CASE PRESENTATION:A 37-year-old man with poorly controlled type 2 diabetes presented with severe right-sided pleuritic chest pain, respiratory splinting, and cough. Two weeks earlier, he had been evaluated at an urgent care for cough and was prescribed a 5-day course of azithromycin for bronchitis. He then presented to...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2019.02.002

    authors: Galant-Swafford J,Light M,Onaitis MW,Rawlings SA,Fierer J,Landsberg JW

    更新日期:2019-07-01 00:00:00

  • Silicone embolism syndrome: a case report, review of the literature, and comparison with fat embolism syndrome.

    abstract::Liquid silicone is an inert material that is utilized for cosmetic procedures by physicians as well as illegally by nonmedical personnel. We present a case report and collated clinical findings of 32 other patients who were hospitalized after illegal silicone injections. Symptoms and signs of the "silicone syndrome" i...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.127.6.2276

    authors: Schmid A,Tzur A,Leshko L,Krieger BP

    更新日期:2005-06-01 00:00:00

  • Release of lipopolysaccharide toxicity-modulating proteins in patients undergoing cardiopulmonary bypass using noncoated and heparin-coated extracorporeal circuits. A clinical pilot study.

    abstract:STUDY OBJECTIVE:Cardiopulmonary bypass (CPB) induces a generalized inflammatory response, including activation of leukocytes, contributing to postoperative morbidity. The inflammatory pathways leading to this systemic inflammatory response syndrome are considered identical to those involved in septic shock. Therefore, ...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.111.3.577

    authors: Bouma M,Maessen J,Weerwind P,Dentener M,Fransen E,de Jong D,Buurman W

    更新日期:1997-03-01 00:00:00

  • The use of learning resource centers in the teaching of pulmonary medicine.

    abstract::Learning resource centers (LRC) are areas designed for individual study which contain a variety of self-instructional materials. To evaluate the use of LRC in teaching pulmonary medicine, a survey was conducted of medical school pulmonary sections; responses were obtained from 30 sections with an NHLBI pulmonary Acade...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.82.5.639

    authors: Make BJ

    更新日期:1982-11-01 00:00:00